APPLICATION FORM – BACKGROUND INFORMATION

Application for Appointment as –

Date available to take up appointment –

Surname –

First Name(s) –

Preferred Title (e.g. Mr, Miss, Mrs, Ms, Dr) –

Date of Birth (optional) –

Address –

Postcode –

Home Telephone Number –

Mobile No –

Email Address –

National Insurance Number –

Date of recognition as a teacher –

Have you completed your NQT induction period? (Yes/No) –

Number of years actually in teaching –

DCSF Number – Date started teaching –

YOUR PRESENT POSITION

Date started at present school/college –

Date started in present post (if different from above) –

Title of Present Post –

Present Salary (including any Incentive Allowances) –

Current TLR Payment Grade (or Leadership scale grade) -

Date TLR/Leadership scale awarded –

Present School/College Name and Address –

Telephone(s) – Email address -

Age range of present school –

Type of School –

Local Authority -

Brief description of current duties –

PLEASE ATTACH COPIES OF YOUR LAST TWO FORMAL LESSON OBSERVATIONS FOR THIS ROLE
SUBJECT AREAS CURRENTLY TAUGHT

Subject/Area

/

Key Stage

/

Date

OTHER SUBJECTS YOU CAN TEACH

Subject/Area
/
Key Stage
/
Date

PREVIOUS TEACHING EXPERIENCE

If necessary, include any additional information in your supporting statement. NQTs should include Teaching Practice.
1. School/College –
LA –
Post and Allowance –
Number on Roll –
Full Time/Part Time –
From/To –
2. School/College –
LA –
Post and Allowance –
Number on Roll –
Full Time/Part Time –
From/To –
3. School/College –
LA –
Post and Allowance –
Number on Roll –
Full Time/Part Time –
From/To –
4. School/College –
LEA –
Post and Allowance –
Number on Roll –
Full Time/Part Time –
From/To –

DETAILS OF IN-SERVICE COURSES

Summarise any recent in-service courses you consider to be relevant to your application.

Date:

/ Course:

DEGREES OR PROFESSIONAL QUALIFICATIONS

Qualification (e.g. BA,Bed) –

University/College –
Class –
Date –
Subjects –

Qualification (e.g. BA,Bed) –

University/College –
Class –
Date –

Subjects –

Qualification (e.g. BA,Bed) –

University/College –
Class –
Date –
Subjects –

EMPLOYMENT OUTSIDE TEACHING

Employer –

Post –
From/To –
Salary –

Employer –

Post –
From/To –
Salary –

TEACHING RECORD

Have you ever had any issues related to Misconduct/Gross Misconduct/Capability or Competency started against you? Yes/No

Has there ever been any type of school internal investigation for your behaviour or conduct at or outside your school? Yes/No

Has the School’s Personnel Service or other related agency ever had to be involved in any matters related to you? Yes/No

If yes, to any of the above questions, please explain:

HOBBIES AND INTERESTS

REHABILITATION OF OFFENDERS

The post for which you have applied will bring you into contact with young people under the age of 18 years. For this reason the post is exempt from the provisions of the Rehabilitation of Offenders Act 1974 and Associated Orders. Applicants are not, therefore, entitled to withhold details of any convictions. You must make a full disclosure of all convictions, however trivial and however old. If the post were offered to you, it would be conditional upon you agreeing to the request of an enhanced disclosure from the Criminal Records Bureau. If that check revealed any undisclosed convictions, the Governing Body would reserve the right to terminate your appointment.
Have you been convicted at any time of any criminal offence including a minor offence involving motor vehicle/s? – Yes / No
If YES, please give details:

PLEASE ATTACH ADDITIONAL SHEETS AS A SUPPORTING STATEMENT

(please include a maximum two page summary with your name at the top and the post title applied for, outlining your skills, experience and suitability to the Post - you may wish to submit an additional CV as well)

REFEREES

Please give THREE referees one of whom should be your Headteacher or current employer. Probationary teachers should give the Principal of their current establishment.
Name –
Relationship to you professionally –
Position –
Address –
Daytime Telephone Number – Mobile No. -
Email address –
Name –
Relationship to you professionally –
Position –
Address –
Daytime Telephone Number – Mobile No. -
Email address –
Name –
Relationship to you professionally –
Position –
Address –
Daytime Telephone Number – Mobile No. -
Email address –
GOVERNING BODY
Are you are related to any member of Thamesview School’s Governing Body or to the Headteacher
Yes / No (If YES, please complete space below with details):

DATA PROTECTION ACT

I understand that personal information that I have provided will be computerised for administrative purposes including statutory returns.

DECLARATION

I do declare that the information I have given in this application form is true and accept that if I have knowingly given false information it may result in my application being no longer considered or my appointment not being confirmed or I being dismissed. I agree that if I am offered the appointment, it will be subject to the Governing Body making checks about me against Police Records of criminal convictions and I hereby agree to such checks being carried out.
Signature –
Date –
Please state where you found out about this vacancy:…………………………………………………………………………
The completed application form should be sent electronically and as a hard copy in the post as soon as possible to:

and
The Headteacher
ThamesviewSchool
Thong Lane
GRAVESEND
Kent
DA12 4LF